What actually happens during a percutaneous nephrolithotomy?
You will be taken to the operating room. General anesthesia will be given. X-ray equipment will be used to guide a small needle into your kidney, and a guide wire can be placed in the kidney through the needle. Larger tubes are passed over the wire, creating a track between the skin and the part of the kidney next to the stone. The urologist is then able to pass a nephroscope (a minimally invasive instrument similar to the ones used for laparoscopic and arthroscopic surgery). At the end of the procedure a narrow plastic tube, called a stent, will be placed in the ureter, which is the tube inside your body which normally drains urine from the kidney to the bladder. This helps drainage of urine from the kidney while you recover from your procedure. A plastic drainage tube, called a catheter, may also be left in the kidney through the original track. This is removed the next day if there are no complications and all of the stone is removed.
Will it hurt?
As the procedure is carried out under a general anesthetic, you will not feel any pain at all. Afterwards, you may experience some tenderness around the small incision and in the kidney. This should not be too uncomfortable, and the ward staff will be able to give you appropriate pain medication if necessary.
Dr. Greenberger is an expert at this technique, and over 90% of patients can expect to leave the hospital completely stone free after a PCNL.
Overview
Percutaneous Nephrolithotomy (also known as PCNL, PNL, and percutaneous nephrolithotripsy) is the most effective treatment for large kidney stones, staghorn calculi, cystine stones, kidneys with multiple stones, and stones associated with UPJ obstruction (a type of renal outlet obstruction). It is also used for patients who have tried lithotripsy but still have a large stone burden.
PCNL has been proven to be more successful and less expensive than ESWL (lithotripsy) for stones larger than 2 cm. ESWL for large kidney stones often requires multiple rounds of lithotripsy, each requiring time off work and several weeks to pass fragments before the next round of treatment. For this reason, even though PCNL is requires hospital admission, the total time off work and recovery is less than ESWL for treatment of these large stones.
Doctors with expertise in incontinence, bladder suspension ("bladder lift") and sling procedures, kidney stones, no needle no scalpel vasectomy, vasectomy reversal, laparoscopy and laparoscopic kidney and prostate surgery, prostate diseases including cancer and enlarged prostate
Adult and pediatric urology, urologic surgery, in Orange County California
Serving Orange, Tustin, Irvine, Santa Ana and Garden Grove
Contact us at (714) 639-1915 and schedule an appointment with Dr. Greenberger to discuss if PCNL is right for your large kidney stone.
